Rapid efficient delivery of bronchodilators is important in the acute care setting. The standard dose volume of 3 mL with 0.083% albuterol sulfate was established for use with standard nebulizers with residual volumes between 0.8 and 2.0 mL. We wanted to determine the effect of dose volume on inhaled mass and time of administration using a nebulizer with a low (<0.1 mL) residual volume.
A low residual volume nebulizer, Aeroneb® Professional Nebulizer (Aeroneb Pro; Aerogen) was used to aerosolize 2500 μg of albuterol sulfate solution in volumes of 3 mL (0.083% solution) and 0.5 mL (0.5 % solution) while attached to a lung simulator (Hans Rudolph) set to adult tidal breathing parameters (tidal volume 500 mL, rate 15 b/min and inhalation time 35%) of a nonintubated subject. Aerosol was collected on an absolute filter distal to the nebulizer mouthpiece. Drug was eluted from the filter and assayed by HPLC (n=3 for each condition).
When the 3.0 mL dose of 0.083% albuterol sulfate was aerosolized, the inhaled mass (mean ± SD) deposited on the filter was 575 ± 23 μg representing 23 ± 1% of the total dose, requiring an average administration time of 428 ( ± 17) seconds. The 0.5 mL of 0.5% albuterol sulfate resulted in an inhaled mass of 540 ± 29 μg, or 22 ± 1 % of total dose, requiring an average administration time of 84 (± 10) seconds.
The inhaled mass from 3.0 and 0.5 mL doses containing 2500 μg of albuterol sulfate with the Aeroneb Pro was similar, however there was a five fold increase in administration time required for the larger dose volume.
Use of a low residual volume nebulizer may reduce the need to dilute medications, and reduce the time required for administration of bronchodilators.
J.B. Fink, None.